Persistence of anaemia among Samoan preschool age children: a longitudinal study

Abstract

Objective: To characterize prevalence and persistence of anaemia among Samoan children over a two-three-year period. Design: Data were from two consecutive waves (2015 and 2017/2018) of the Ola Tuputupua’e “Growing up” study. Anaemia (haemoglobin <11·0 or 11·5 g/dL for 2-4 and ≥5 years olds, respectively) was considered “transient” when it occurred at only one wave or “persistent” if it was present at two consecutive waves. Child, maternal, and household correlates of anaemia were examined using log-binomial and modified Poisson regressions. Setting: Eleven Samoan villages Participants: Mother-child pairs (n=257) recruited in 2015 and re-assessed in 2017/2018. Results: Anaemia prevalence was 33·9% in 2015 and 28·0% in 2017/2018; 35·6% of cases identified in 2015 were persistent. Risk of anaemia at only one wave was lower among children who were older in 2015 (age 4 vs. 2 years, aRR=0·54, 95% CI:0·35-0·84, P=0·007), had older mothers (≥40 vs. 18-29 years, aRR=0·61, 95% CI:0·39-0·95, P=0·029), and had higher daily sodium intake (for every 100 mg/day, aRR=0·97, 95% CI:0·95-0·99, P=0·003) than children with no anaemia. Children whose anaemia persisted were more likely to have had a mother with anaemia (aRR=2·13, 95% CI:1·17-3·89, P=0·013) and had higher daily dietary iron intake (for every 10 mg/day, aRR=4·69, 95% CI:1·33-16·49, P=0·016) than those with no anaemia. Conclusions: Alongside broadly targeted prevention efforts, which are warranted given the moderate-high anaemia prevalence observed, specific attention should be paid to children with risk factors for persistent anaemia. Routine screening of children whose mothers have anaemia should be encouraged.